骨折后锁定钢板与螺钉的历史与进展

Justin Rowe
MATHYS CHINA
Cancellous bone
Cancellous bone screws
Justin Rowe
MATHYS CHINA
Cancellous Bone Screw
• • • • Conventional Stainless Steel Titanium Different Diameter - 6.5mm ( Basic ) - 4.0mm ( Small Fragment ) • Full & Partial Threaded
LC-DCP
Intrinsic Story
• Realizes the concept of
biological internal fixation • Minimizes vascular damage to the plated bone segment • More versatile and efficient application of internal fixation
Justin Rowe
MATHYS CHINA
LC-DCP
Limited Contact - Dynamic Compression Plate LC-DCP Holes
• • • • Provides bidirectional compression Allows 80o of longitudinal screw angulation Allows 14o of transverse screw angulation Uniform hole spacing provides greater intraoperative flexibility for screw and plate placement
Justin Rowe
MATHYS CHINA
Compression of plate on cortex reduces blood supply
Justin Rowe
MATHYS CHINA
Influence to the bone
LC-DCP
DCP
Justin Rowe MATHYS CHINA
Premanufactured specialty plates
Lateral Tibial Head Buttress Plate For proximal tibia and distal femur
• • • • • • • Right ( Left Angled ) Left ( Right Angled ) Stainless Steel & PureTitanium Buttress combined with DCP 4.5 and 6.5 mm screw compatible 5~13 holes (2 holes interval) 117~245 mm in length ( 32mm interval )
Justin Rowe MATHYS CHINA
Premanufactured specialty plates
Condylar Buttress Plate 4.5 For multiple fragment fracture of femoral condyles
• • • • • Right & Left Stainless Steel Buttress Plate with DCP Shaft 4.5 & 6.5 mm screw compatible 7~15 holes ( 2 holes / interval )
MATHYS CHINA
1 3
2 Compression:
Plate
Bone with screw
Justin Rowe MATHYS CHINA
LC-DCP
Limited Contact - Dynamic Compression Plate
Justin Rowe
MATHYS CHINA
LC-DCP
Justin Rowe
MATHYS CHINA
Justin Rowe
MATHYS CHINA
Screws & Plates
• • • • • • •
Types of screws Indications of plates and screws Lag screw principle Combination of plates and screws DCP (Dynamic Compression Plate) LC-DCP (Limited Contact - DCP) Pre-manufactured Plate
MATHYS CHINA
Wrong
Correct
Screws in a 90 o to fracture line
Justin Rowe
MATHYS CHINA
(Dynamic Compression Plate) DCP Plate
Justin Rowe
MATHYS CHINA
Justin Rowe
Justin Rowe
MATHYS CHINA
LC-DCP
Limited Contact - Dynamic Compression Plate
Uniform Stiffness
• Allows smooth contour of plate to bone • Protects plate from localized high bending stresses
Justin Rowe
MATHYS CHINA
Cancellous Bone Screw
6.5mm
Thread Diameter: Drill bit:
Core: Hexagonal: Tap: Shaft: Thread Length:
4.0mm
4.0mm 2.5mm 2.5mm 1.9/2.0mm 2.5mm 4.0mm 2.4mm 5~16mm
Spoon Plate 4.5 V-shape for frontal edge of the tibia and metaphyseal fracture of Humerus and Tibia
• • • • Stainless Steel & PureTitanium Buttress Plate with sliding hole* 5 and 6 holes 100 and 120 mm in length
Limited Contact - Dynamic Compression Plate
Reduced contact on cortex due to limited contact plate because of undercuts
Justin Rowe MATHYS CHINA
Limited Contact - Dynamic Compression Plate
Justin Rowe MATHYS CHINA
Premanufactured specialty plates
Cobra Head Plates 4.5 mm St.Steel For Hip Arthrodesis
Justin Rowe MATHYS CHINA
Premanufactured specialty plates
Justin Rowe MATHYS CHINA
Cortex Screw
4.5mm
Thread Diameter: Drill bit:
Core: Hexagonal: Taቤተ መጻሕፍቲ ባይዱ: Shaft:
3.5mm
3.5mm 2.5mm 3.5mm 2.4mm 2.5mm 3.5mm 3.5mm
4.5mm 3.2mm 4.5mm 3.0/3.1mm 3.5mm 4.5mm 4.5mm
Justin Rowe MATHYS CHINA
Cortex bone
Cortex screws
Justin Rowe
MATHYS CHINA
Cortex Screw
• • • • • Conventional Self-tapping Stainless Steel Titanium Different Diameter - 4.5mm ( Basic ) - 3.5mm ( Small Fragment ) • Full threaded & Shaft Screw
Justin Rowe
MATHYS CHINA
LC-DCP
Limited Contact - Dynamic Compression Plate
Grooved Undercut Surface
• Provides limited contact between plate and bone minimizing the chance for temporary osteoporosis under the plate • Allows for periosteal callus formation at the fracture site
6.5mm 3.2mm 4.5mm 3.0/3.2mm 3.5mm 6.5mm 4.5mm 16/32mm
Justin Rowe
MATHYS CHINA
Lag screw principle
Goal:
Fracture compression and stable fixation
Justin Rowe
MATHYS CHINA
Lag screw principle
Screw
Gliding hole
Fracture line
Threaded hole
Justin Rowe MATHYS CHINA
Tap
Threaded hole
Gliding hole
Screw diameter
Justin Rowe
Justin Rowe MATHYS CHINA
Screw types
• • • • • • Cortex screws Cancellous bone screws Shaft screws - different thread lenghts Stainless steel - Titanium screws Screw sizes (diameter, lenghts) Cannulated screws